| Objective:To provide a scientific basis for the prevention and treatment of peripheral neuropathy and lower extremity angiopathy disease in type 2 diabetes,we explored the influencing factors of peripheral neuropathy and lower extremity angiopathy disease and analyzed the correlation between them in type 2 diabetes.Method:A total of 326 patients with type 2 diabetes were recruited in Department of Endocrinology,Shenyang Red Cross Hospital from October 2017 to June 2018,including 179 males and 147 females.Collect the general information of subjects,including sex,age,height,weight,body mass index,smoking history,course of diabetes mellitus,etc;blood biochemical indexes:triglyceride(TG),lipoprotein(a)(LP(a)),glycosylated hemoglobin(HBA1C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),uric acid(UA),etc,lower extremity artery color doppler ultrasound imaging and nerve conduction velocity detection were performed on each subject.According to the results of the examination,all subjects were divided into four groups:simple diabetes group(DM group,64 cases),combined with peripheral neuropathy group(DPN group,77 cases),combined with lower extremity angiopathy group(LEAD group,80 cases)and combined with peripheral neuropathy and lower extremity angiopathy group(combined group,105cases).Software SPSS 18.0 was used to perform statistical analysis to identify the differences of each index among four groups.For measurement data,the mean ± standard deviation or median and quartiles were used to measure,the t/rank sum test was used to compare the differences between the different groups.For counting data,the ratio or rate was used to measure,and the x2/rank sum test was used to compare the differences between the different groups.Logistic regression analysis was used to explore the risk factors of peripheral neuropathy and lower extremity angiopathy disease.Speraman correlation analysis was used to explore the correlation between peripheral neuropathy and lower extremity angiopathy disease in type 2 diabetes.Result:1.General conditions:(1)Compositions of age and gender:in this study,there were 179 male patients(54.9%)and 147 female patients(45.1%),and the ratio of male to female was 1.22:1,the youngest was 26 years old,the oldest was 86 years old,the average age was 60 years old.(2)Body measurement index:207(63.5%)of the cases with BMI?24;waist circumference:135(41.4%)for males?90cm,and 135(41.4%)for females?85cm.(3)The incidence of DPN was higher in subjects with family history of diabetes than those without family history of diabetes,the subjects with history of hypertension had higher incidence of LEAD than those without hypertension.(4)Diabetes course:the course of diabetes in all subjects was 0-36 years,and the average course of disease was 10 years.With the prolongation of diabetes,the incidence of DPN gradually increased,the incidence of DPN was more than 60%in cases with diabet course of 10 to 25 years,and the incidence of DPN in the course of diabet?25 years was 85.71%.If group by diabet course of<10years,10-20 years,?20 years,the detection rate of LEAD also showed a significant increase trend,which was 47.4%,62.0%,75.64%.2.Influencing factors analysis of DPN?LEAD?DPN+LE AD.(1)Comparison of data between the DPN group and the DM group:There were significant differences between the two groups in terms of adequate sleep time,family history of diabetes,monthly income per capita,duration of diabetes,LP(a),UA and ALT(P<0.05).The duration of diabetes and mean value of LP(a)in group DPN were significant higher than those in group DM,and the average values of UA and ALT in group DPN were significant lower than those in DM group.Multivariate logistic regression analysis showed that the duration of diabetes was an independent risk factor for the occurrence of DPN(OR=1.081?P<0.05).(2)Compared with the data of patients with LEAD and DM:There were significant differences in hypertension,drinking history,adequate sleep time,family income per capita,age,course of diabetes,HBAlC,TG,UA,ALT,AST,cholinesterase,albumin,waist circumference and BMI between the two groups(P<0.05).The average age and duration of diabetes in group LEAD were longer than those in group DM;the average values of ALT and BMI in group LEAD were lower than those in group DM.Multivariate Logistic Regression analysis showed that age was an independent risk factor for LEAD(OR=1.094,P<0.05).(3)Comparison of data between the two groups in the combined group and the DM group:There were significant differences in hypertension,drinking history,adequate slep time,family income per capita,age,course of diabetes,HBAlC,TG,UA,ALT,AST,cholinesterase,albumin,waist circumference and BMI between the two groups(P<0.05).The mean age,the duration of diabetes and the average HBAlC of the combined group were all higher than those of DM group;the mean values of TG,UA,ALT,AST,cholinesterase,albumin,waist circumference and BMI in the combined group were lower than those in the DM group.Binary Multivariate Logistic regression analysis showed that age,long course of disease and elevated HBA1C were independent risk factors for DPN+LEAD(OR=1.098.1.121?1.538?P<0.05).3 Correlation analysis between DPN and LEAD:(1)Comparing the severity of neuropathy between DPN group and combined group,Z=-3.665,P<0.05,which indicated that vascular disease is associated with the occurrence of neuropathy;(2)Comparing the severity of vasculopathy between LEAD group and combined group,Z=7.719,P<0.05,which indicates that neuropathy is related to the occurrence of vascular diseases;(3)All the subjects were grouped by the severity of vascular and neuropathy.Spearman correlation analysis showed that the R value was 0.154,P<0.05,which indicated that the severity of DPN was correlated with the severity of LEAD.Conclusion:1.The family history of diabetes mellitus and the increase of LP(a)may be the influencing factors of DPN occurrence;hypertension may be the influencing factors of LEAD and DPN+LEAD;smoking may be the influencing factors of LEAD.2.Low per capita income and insufficient sleep time may be the influencing factors of DPN and DPN+LEAD.3.Long duration is an independent risk factor for DPN;age is an independent risk factor for LEAD;age,long course of disease and elevated HBA1C were independent risk factors for DPN + LEAD.4.The severity of DPN is positively correlated with the severity of LEAD.Risk factors of DPN and LEAD must be strictly controlled to delay the development of diabetic complications. |
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